Health-related learning needs and interests of selected non-institutionalized elderly

The research question in this study was "How do the noninstitutionalized elderly in the Hamilton-Wentworth Region perceive their learning needs and interests related to health?" The theoretical foundations of instruction for adults were reviewed as well as learning needs and interests in adult education, the assessment of learning needs in general, and the assessment of the learning needs of the elderly. The methodology used was a descriptive design. A research-based questionnaire-interview was developed, refined, and pilot tested. From a random sampling procedure, a participant group of 23 was secured. The questionnaireinterview was administered in a home visit situation. Data, which were collected, were coded, analyzed, processed, and printed. The results indicated that each participant had many learning needs and interests of varying intensities. The participants had many preferences in the delivery of health promotion. The learning needs and interests had several significant correlations with other variables. The implications of the result~ were discussed.

Health-related quality of life among patients attending cardiovascular rehabilitation

Purpose: f i rst , an investigation of baseline differences in Health-Related Quality of l i fe (HRQOl) among adhere and non-adhere patients of Phase III cardiac rehabilitation (CR) was examined. Second, among patients who adhered to the program, effectiveness of t reatment based on HRQOl was evaluated. Methods: Data was collected by the Brock University Heart Institute. Participants completed a questionnaire battery at baseline and again at six months i f they were still a client. Results: The physical dimension of HRQOl differed at baseline between the adhere and non-adhere groups. for everyone point increase in physical HRQOl scores there was an associated 1.06 times greater likelihood that an individual would adhere to the program. Second, in those who adhered to the program for six months, physical HRQOl scores improved 3.18 points. Conclusions: Phase III CR significant improves HRQOl in patients suffering f rom cardiovascular disease.

Sustaining Health Care Practice Change: The Experience of Best Practice Spotlight Organizations Implementing and Sustaining RNAO Best Practice Guidelines

Sustainability of change for improvement initiatives has been widely reported as a global challenge both within and outside health care settings. The purpose of this study was to examine the extent to which factors related to staff training and involvement, staff behaviour, and clinical leaders’ and senior leaders’ engagement and support impact the long term sustainability of practice changes for BPSO health care organizations who have implemented Registered Nursing Association of Ontario’s (RNAO) Best Practice Guidelines. Semi structured interviews with eleven organizational leaders’ from ten health care organizations were conducted to explore the unique experiences, views and perspectives on factors related to staff, clinical leaders and senior leaders and their involvement and impact on the long term sustainability of clinical practice changes within organizations who had implemented Registered Nursing Association of Ontario’s (RNAO) Best Practice Guidelines (BPGs). The interviews were coded and analyzed using thematic content analysis. Further analysis identified patterns and themes in relation to: 1. The National Health Service (NHS) Sustainability Model which was used as the theoretical framework for this research; and 2. Organizations found to have sustained practice changes longer term verses organizations that did not. Six organizations were found to have sustained practice changes while the remaining four were found to have been unsuccessful in their efforts to sustain the changes. Five major findings in relation to sustainability emerged from this study. First is the importance of early and sustained engagement and frontline staff, managers, and clinical leaders in planning, implementation and ongoing development of BPGs through use of working groups and champions models. Second is the importance of ongoing provision of formal training, tools and resources to all key stakeholders during and after the implementation phase and efforts made to embed changes in current processes whenever possible to ensure sustainability. Third is to ensure staff and management are receptive to the proposed change(s) and/or have been given the necessary background information and rationale so they understand and can support the need for the change. Fourth is the need for early and sustained fiscal and human resources dedicated to supporting BPG implementation and the ongoing use of the BPGs already in place. Fifth is ensuring clinical leaders are trusted, influential, respected and seen as clinical resources by frontline staff. The significance of this study lies in a greater understanding of the influence and impact of factors related to staff on the long term sustainability of implemented practice changes within health care organizations. This study has implications for clinical practice, policy, education and research in relation to sustainability in health care.